Department for Business, Energy and Industrial Strategy

Use of the Industrial Development Act 1982 for Coronavirus related assistance

Lord Callanan: My Honourable friend the Minister for London and Parliamentary Under Secretary of State (Minister for Small Business, Consumers and Labour Markets) (Paul Scully) has today made the following statement:I am tabling this statement for the benefit of Hon. Members to bring to their attention spend under the Industrial Development Act 1982. In addition to the obligation to report on spend under the Industrial Development Act annually, the Coronavirus Act 2020 created a new quarterly reporting requirement for spend which has been designated as coronavirus-related under the Coronavirus Act. This statement fulfils that purpose.The statement also includes a report of the movement in contingent liability during the quarter. Hon. Members will wish to note that measures such as Local Authority grants, the Coronavirus Job Retention Scheme and Self-Employed Income Support Scheme, and tax measures such as the suspension of Business Rates are not provided under the Industrial Development Act 1982 and hence are not included below.This report covers the first quarter of 2021, from 1 January to 31 March 2021, in accordance with the Coronavirus Act. The Written Ministerial Statement covering the fourth quarter of 2020 was published on May 17th, 2021. Spend under the Coronavirus Act 2020Under the Coronavirus Act 2020, there is a requirement to lay before Parliament details of the amount of assistance designated as Coronavirus related provided in each relevant quarter. In the period from 1 January to 31 March 2021, the following expenditures were incurred: Actual expenditure of assistance provided by Her Majesty’s Government from 1 January to 31 March 2021£ 1,058,687,252All expenditure of assistance provided by Her Majesty’s Government from 25 March 2020£ 2,699,037,690 Expenditure by Department Actual expenditure of assistance from 1 January to 31 March 2021 provided by: Department for Business, Energy and Industrial Strategy£ 968,013,744Department for Transport£ 86,925,000Department for Environment, Food & Rural Affairs,£ 3,748,507 Contingent liability under the Coronavirus Act 2020 Contingent liability of assistance provided by the Secretary of State from 1 January to 31 March 2021£ 5,666,529,651All contingent liability of assistance provided by the Secretary of State from 25 March 2020£ 66,855,181,895

Department of Health and Social Care

Government Responses to the CQC ‘Out of Sight - Who Cares?’ Report and to Baroness Hollins’ Interim Report on Seclusion and Restrictive Practice for People with a Learning Disability and Autistic People

Lord Bethell: My Hon. Friend the Minister of State (Minister for Care) (Helen Whately), has today made the following written ministerial statement:Today we have published two formal responses to independent reports that the then Secretary of State for Health and Social Care commissioned to address and reduce the use of restrictive practice in the care of people with a learning disability or autistic people. The first response is to the recommendations made by the Care Quality Commission (CQC) in its report 'Out of Sight – who cares?' published on 22 October 2020. The second response is to the independent interim report by Baroness Hollins reviewing the care and treatment of people with a learning disability or autistic people in long term segregation. A copy of these responses will be deposited in the Libraries of both Houses.We welcome these reports and strongly support their recommendations. It is our priority to ensure that the rights of people with a learning disability or autistic people are protected and that where needed they receive high-quality care in the least restrictive settings possible.We have carefully considered these recommendations and are accepting in full or in principle the vast majority, including:Developing a pilot for a Senior Intervenor role, which will be focused on reducing the length of time people with a learning disability or autistic people remain unnecessarily in inpatient care in segregation. The pilot will be funded as part of a wider package of £31m to support learning disability and autism services, to address the diagnostic backlog as a result of the pandemic, and support intervention to prevent children and young people with learning disability, autism or both escalating into crisis.Working with the Royal College of Psychiatrists to define good practice with respect to admission and discharge protocols, including the development of a clinical contract for admissions.Supporting the continuation of an independent review process which provides necessary scrutiny in the care and treatment of people who are subject to segregation. The reviews, chaired by independent experts, are aimed at developing bespoke recommendations, offering advice on implementing person-centred care plans and, where appropriate, moving the individual to less restrictive settings.Working with the CQC to ensure more transparent reporting about the use of restrictive interventions in order to improve practice and minimise all types of force used on patients so that it is genuinely only ever used as a last resort.Our goal is to ensure that care for people with a learning disability and autistic people is therapeutic and beneficial and that the presumption is always that, individuals can be supported to live fulfilling lives in the community. We remain committed to delivering on the Government’s manifesto commitment to improve how people with a learning disability and autistic people are treated in law and to make it easier for them to be discharged from hospital. The steps we are taking in responding to these recommendations support this commitment and are part of our wider work on Building the Right Support and the Mental Health Act White Paper.

Publication of the national strategy for autistic children, young people and adults: 2021 to 2026

Lord Bethell: My Rt Hon Friend the Secretary of State for Health and Social Care (Sajid Javid) has today made the following written ministerial statement:Today I am announcing the publication of ‘The national strategy for autistic children, young people and adults: 2021 to 2026’. The strategy is aimed at significantly improving the lives of autistic people in England.This strategy builds on improvements made over the decade since the inception of the Autism Act in 2009. The Autism Act was enacted to tackle the multiple disadvantages that autistic people face. It is estimated that around 560,000 people in England are autistic and that autistic people die on average 16 years earlier than the general population. They experience poorer overall health outcomes and face substantial health inequalities in comparison to non-autistic people.Since the Act’s introduction, there have been two strategies, which have resulted in improved availability of services for autistic people, including diagnostic services, and significantly improved public awareness of what autism is. I want to pay particular tribute to our late colleague, my Rt Honourable Friend Dame Cheryl Gillan DBE MP, who was so instrumental in bringing forward this Act in 2009. She worked tirelessly to improve autistic people and their families’ access to services through her role as Chair of the All Party Parliamentary Group on Autism (APPGA).Today, I am delighted to announce the publication of the third iteration of the autism strategy, which sets out our vision for how we will make further progress on improving the lives of autistic people over the next 5 years. We have worked with my colleague Vicky Ford MP, Parliamentary Under-Secretary of State for Children and Families on this new strategy, which extends to children and young people for the first time. This is in recognition of the importance of supporting autistic people throughout their lives, from the early years of childhood and through adulthood. We have also worked in partnership with other government departments to ensure the strategy addresses the wide range of issues that affect autistic people's whole lives.The focus of this new strategy and the actions we are committing to have been informed by evidence including our National Call for Evidence undertaken in 2019, which received 2,745 responses from autistic people, their families and unpaid carers as well as organisations. We also involved self-advocates and family members in the development of the new strategy through our Autism Strategy Executive Group. In addition, the strategy was informed by the APPGA’s ‘The Autism Act, Ten Years On’ report and independent research we commissioned about the impact of the COVID-19 pandemic on autistic people, both of which involved autistic people and their families. I know the pandemic has created new challenges and exacerbated problems many autistic people already faced, including higher levels of loneliness and social isolation.Today we also publish our response to the CQC’s ‘Out of sight – who cares?’ report and our response to Baroness Hollins’ and the independent Oversight Panel’s recommendations regarding independent reviews for people with a learning disability and autistic people detained in long term segregation.The new autism strategy is supported by an implementation plan for 2021 to 2022, which sets out actions we will take forward in the first year of the strategy. We will publish further implementation plans for subsequent years of the strategy, in line with future spending review rounds. The strategy sets out our vision for what we want autistic people and their families’ lives to be like in 2026 across 6 priority areas, and the specific steps we, local government, the NHS and others will take to this end in this first year:Improving understanding and acceptance of autism within society. To ensure that autistic people can take part in their communities without fear or judgment, just like everyone else, we are funding the development of and will test an autism public understanding initiative.Improving autistic children and young people’s access to education, and supporting positive transitions into adulthood. To enable children and young people to access the right support, we are providing funding to train education staff in autism, and we are strengthening and promoting pathways to employment, such as Supported Internships, traineeships and apprenticeships.Supporting more autistic people into employment. We will continue with our efforts to make Jobcentres more autism-inclusive, improve employer awareness and promote better access to employment support programmes for autistic people.Tackling health and care inequalities for autistic people. To tackle these inequalities, we are investing £13 million to begin reducing diagnosis waiting times for children and young people, as well as adults, in line with the NHS Long Term Plan and the Mental Health and Wellbeing Recovery Action Plan.Building the right support in the community and supporting people in inpatient care. To make progress towards our targets of reducing the number of autistic people and people with a learning disability in inpatient mental health settings, we will take a number of actions. We are proposing to change the detention criteria in the Mental Health Act (1983) to prevent autistic people without a co-occurring mental health condition from being detained for treatment under section 3 of the Act. In addition, we are investing £40 million to improve community support, over £18 million to drive improvements in the quality of inpatient care and providing £21 million as part of the Community Discharge Grant to speed up discharges.Improving support within the criminal and youth justice systems. To improve autistic people’s experience with the criminal and youth justice systems, we will develop a training toolkit for frontline staff on neurodiversity and the additional support people might need. We will also take a number of steps to improve staff awareness and understanding of autism and improve people’s access to adjustments.Over the next 5 years, we will work together to create a society that truly understands and includes autistic people in all aspects of life; one in which autistic people of all ages, backgrounds and across the country have equal opportunities to play a full part in their communities and to have better access to the services they need throughout their lives.

Publication of the Government response to the Report of the Independent Medicines and Medical Devices Safety Review (IMMDS Review)

Lord Bethell: My Hon Friend the Minister for Patient Safety, Suicide Prevention and Mental Health (Nadine Dorries) has today made the following written ministerial statement:The Report of the Independent Medicines and Medical Devices Safety Review (IMMDS Review) was published on 8 July 2020.On 11 January, I updated the House on the government’s progress in responding to the recommendations of the IMMDS Review.I am pleased to today announce to the House the publication of the government’s full response to the IMMDS review. We have accepted four of the nine strategic recommendations in full, one in principle and two in part. We have also accepted 46 of the 50 Actions for Improvement in full or in principle, one in part and one remains under consideration. We do not accept two of the Actions for Improvement.This response sets out an ambitious programme of change, which at its core is about improving patient safety by:improving how the system listens to and responds to concerns raised by patients by putting patient voice at the centre of patient safety;strengthening the evidence base on which decisions are made, including through making sure the right data is collected and used; andimproving the safety of medicines and devices, and embracing the new opportunities following the UK’s departure from the European Union to reform regulatory frameworks.Recommendation 1: the government should immediately issue a fulsome apology on behalf of the healthcare system to the families affected by Primodos, sodium valproate and pelvic mesh.The government accepts recommendation 1.In July 2020, the government apologised in full on behalf of the healthcare system to all the families affected by report for the time it has taken to listen and respond to their concerns. I salute their courage and persistence in coming forward to make these concerns heard; without their bravery, the review would not have been possible.Listening to patients The Review was commissioned because the government recognised and accepted that the system had taken too long to listen to patients. One of the key conclusions from the Report was that ‘the system has not been listening as it should’. The government recognised the need for effective patient engagement to rebuild trust and ensure that patient voice was embedded in work to develop the full government response to the Report. We were pleased to announce in January that we had accepted the second part of the Report’s ninth recommendation, for the establishment of a Patient Reference Group (the ‘Group’).The purpose of the Group was to provide challenge, advice and scrutiny to the work to develop the government’s response to the Report’s recommendations. The Group represented a diverse range of experiences, and members include individuals who have been affected by or have an interest in pelvic mesh, sodium valproate, and Hormone Pregnancy Tests (HPTs), those who have been affected by or have an interest in other medicines or medical devices, and also those with a wider interest in patient safety. The Group met regularly and worked closely with officials to discuss the Report’s recommendations in great detail. I met with the Group in June to listen to their feedback directly.We are extremely grateful to the Group for their insight and honesty. The government response has undoubtedly been strengthened through listening to and learning from group members’ experiences, knowledge and expertise. I am very pleased that the final report of the Patient Reference Group has been published alongside the government response today.Recommendation 2: the appointment of a Patient Safety Commissioner who would be an independent public leader with a statutory responsibility. The commissioner would champion the value of listening to patients and promoting users’ perspectives in seeking improvements to patient safety around the use of medicines and medical devices.The government accepts recommendation 2.Patient safety is a top priority for the healthcare system; we want to make the NHS the safest healthcare system in the world, and we must retain an absolute focus on achieving this goal.As Members will know, the central recommendation in the Report is for the establishment of an independent Patient Safety Commissioner.The government has accepted this recommendation, and we have already legislated for a Patient Safety Commissioner through the Medicines and Medical Devices Act 2021 (MMD Act).It is integral that patients are listened to in our healthcare system and the Commissioner will help to make sure patient voices are heard, as envisaged in the Report of the IMMDS Review.The core role of the Commissioner will be to promote the safety of patients in the context of the use of medicines and medical devices and to promote the importance of the views of patients and other members of the public in relation to the safety of medicines and medical devices.A public consultation is currently open seeking views on the proposed legislative details on the appointment and operation of the Commissioner. The consultation closes on 5 August 2021. After the consultation has closed, responses will be carefully considered and reviewed, and will feed into the drafting of the regulations on the appointment and operation of the Commissioner.We plan to have the first Patient Safety Commissioner in post in the first half of 2022.Recommendation 3: a new independent Redress Agency for those harmed by medicines and medical devices should be created based on models operating effectively in other countries. The Redress Agency will administer decisions using a non-adversarial process with determinations based on avoidable harm looking at systemic failings, rather than blaming individuals.The government does not accept recommendation 3As set out in the January statement, we have no current plans for a redress agency, as set out in recommendation 3.We do not believe it is necessary to create a new agency for redress as it is already possible for the government and others to provide redress for specific issues where that is considered necessary. Neither do we believe that creating an agency would succeed in making products safer as the report suggests, or that grouping existing redress schemes through a single front door would add value for harmed patients.Recommendation 4: separate schemes should be set up for each intervention – hormone pregnancy tests (HPTs), valproate and pelvic mesh – to meet the cost of providing additional care and support to those who have experienced avoidable harm and are eligible to claim.The government does not accept recommendation 4.While the government is sympathetic to the experiences of those patients who gave evidence to the report, our priority is to improve the future safety of medicines and medical devices. This includes not just the products themselves but also ensuring they are used in line with the latest evidence of best practice – in ways that are both effective and safe for patients. This means we will continue to focus our work on direct support for future safety, improve how the system listens to patients, and support and monitor the safety of clinical practice where medicines and devices are concerned. The MMD Act delivers further on our commitments to patient safety, embedding reform through legislation and delivering an ambitious programme of improvements medicines and medical devices.Recommendation 5: networks of specialist centres should be set up to provide comprehensive treatment, care and advice for those affected by implanted mesh; and separately for those adversely affected by medications taken during pregnancy.The government accepts recommendation 5 in part.The government accepts the first part of recommendation 5; specialist centres for those adversely affected by implanted mesh.Much progress has been made to establish the specialist mesh services, led by NHS England and Improvement. These services became operational on 1 April 2021, and there are now 8 specialist centres in operation across England. Good progress is being made towards the establishment of a ninth regional service with a South West provider, to ensure patients across the country can access these vital services. It is important that women have choice over their surgeon where possible and I am happy to confirm that when patients request treatment for mesh complications, they can exercise patient choice and be referred to another centre if they wish.The Report of the IMMDS Review highlights the importance of the specialist services working together re-enforced the need for the commissioned mesh services to network across providers to ensure each service provides comprehensive treatment, care and advice services. I am pleased to confirm that the providers of specialised services for women with complications of mesh will meet annually from 2021 at a Clinical Summit to discuss data and outcomes.Recognising the need for enhanced data collection on pelvic mesh, the government in 2018 announced the provision of £1.1m for the development of a comprehensive database of urogynaecological procedures, including vaginal mesh, to treat pelvic organ prolapse and stress urinary incontinence. I can update the House that the pelvic floor information system has started to receive live data, including historical data from July 2017 onwards, with an initial focus on supporting specialist services to report every pelvic floor and comparative procedure to this national database.The Report of the IMMDS Review also recommends that the information system is accompanied by a retrospective audit of mesh procedures, and by the development of a patient reported outcome measure (PROM) or patient reported experience measure (PREM). I am pleased to announce to the House today that the government accepts both these recommendations. NHS Digital has been commissioned to scope and deliver the retrospective audit. Subject to receiving high quality research bids, a new validated PROM for pelvic mesh procedures will be commissioned through the National Institute of Health Research in 2022. Additionally, earlier this year a £440,000 research study into ‘Experiences of Urogynaecological services’ was commissioned by the NIHR to feed into this vital work to develop a new PROM.The government does not accept the second part of recommendation 5, specialist centres for those adversely affected by medications taken during pregnancy.We recognise the underlying issue that there is a need to improve the care and support for the individuals and families affected by a range of medicines used in pregnancy, including valproate exposure. However, our view is that a network of new specialist centres is not the most effective way forward. We will instead take forward work to improve the care pathways for children and families affected by medicines in pregnancy, within existing services. This will include strengthening care pathways and tackling the variation in access to services across NHS regions.Currently, services for all children with neurodevelopmental disorders are primarily managed by multidisciplinary teams within Child Development Centres, which are commissioned locally. These are then supported by regional clinical networks, and specialised neuroscience centres. A limited number of specialist centres focussed only on those affected by medications in pregnancy would not be able to provide the whole range of services that patients need, for example coordinating provision across local health, education and social care systems. It is important that patients who need ongoing care can access services as conveniently as possible, and many of these services are better delivered at a local level. Additionally, a new network of specialist centres could divert clinical expertise and potentially result in a reduced service for all the patient groups involved.We will also continue work to improve the safety of medicines in pregnancy more widely, and to ensure that valproate is only prescribed where clinically appropriate.Sodium Valproate The Report of the IMMDS Review discusses sodium valproate (valproate) in much detail and contains a number of actions for improvement related to valproate. For this reason, we have dedicated a chapter in the government response to valproate.The January statement updated on the significant work underway to ensure valproate is only used where clinically appropriate, and to improve patient safety for women and girls for whom there is no alternative medicine. The government does not however support calls to eliminate the use of valproate completely; for some women, it is the only drug which is able to control their epilepsy, and it is vital that women are able to access effective treatments.I am pleased to update the House that much progress continues to be made. The first report from the valproate registry was published on 11 February 2021, and a second is planned for September 2021. The first report presents an important step to improving our ability to monitor implementation and compliance with the Pregnancy Prevention Programme. There are plans to extend the registry to the whole of the UK and to expand it to include other anti-epileptic drugs later this year, as recommended by the Report. As recommended by the Report, NHS England and Improvement have recently sent a letter to all women of childbearing age who are prescribed valproate, including important safety reminders in relation to contraception, pregnancy and regular prescribing reviews.I have also heard from patients that measures to reduce valproate prescribing and support women to make informed choices must be holistic and wide-ranging. I am pleased to announce that the MHRA is planning to consult on an amendment to the Human Medicines regulations which would require pharmacists to supply sodium valproate in the manufacturers original pack with a patient informational leaflet. This will ensure that prescriptions for valproate are dispensed with a patient information leaflet and information on risk minimisation measures.Recommendation 6: the Medicines and Healthcare products Regulatory Agency (MHRA) needs substantial revision particularly in relation to adverse event reporting and medical device regulation. It needs to ensure that it engages more with patients and their outcomes. It needs to raise awareness of its public protection roles and to ensure that patients have an integral role in its work.The government accepts recommendation 6.In the January Statement the government announced that the MHRA initiated a substantial programme of work to improve how it listens and responds to patients and the public, to develop a more responsive system for reporting adverse incidents, and to strengthen the evidence to support timely and robust decisions that protect patient safetyThis is set out in detail in the MHRA’s corporate delivery plan for 2021-23, ‘Putting patients first – a new era for our Agency’, which was published on 4 July. This sets out the MHRA’s future plans, which centre on: putting patients first; becoming a truly world-leading, enabling regulator; and protecting public health through excellence in regulation and science.A key strand of this work is improving how the MHRA engages with patients, and ensures patients have an integral role in its work. In May this year, the MHRA published its draft Patient and Public Involvement Strategy for public consultation. This sets out how the Agency will deliver a step change in its involvement and engagement with patients. Following the consultation, the MHRA will publish the final strategy later this year.I am pleased to confirm to the House that the MHRA’s newly appointed Chief Safety Officer will lead the MHRA's ongoing implementation of the recommendations from the Report. This will help to ensure that the MHRA continues delivering on their commitment to keep patients safe. The post holder will oversee the development of a revitalised approach to vigilance of both medicines and medical devices.Recommendation 7: a central patient-identifiable database should be created by collecting key details of the implantation of all devices at the time of the operation. This can then be linked to specifically created registers to research and audit the outcomes both in terms of the device safety and patient reported outcomes measures.The government accepts recommendation 7.The government has legislated for a patient identifiable database in the MMD Act, which creates a power for the Secretary of State to regulate for the establishment of a UK-wide Medical Device Information System (MDIS)The Report of the IMMDS Review rightly identifies the need for the healthcare system to centralise and standardise the collection, retention and analysis of data for monitoring the safety and effectiveness of implantable medical devices. In order to close the gap identified in the collection and analysis of this data, it is essential that the UK has a comprehensive system to ensure that implantable devices are effectively monitored and any issues affecting patient safety are responded to appropriately. As required by the MMD Act, the government is planning to hold public consultation on the MDIS regulations. Formal public consultation on the MDIS regulations will begin later this year with the aim of laying the regulations in 2022.Alongside developing regulations, I can announce that over £11m has been set-aside for a package of work in 2021/22, involving partners across the healthcare system to scope, test and cost options for MDIS and other medical devices patient safety workstreams.Recommendation 8: transparency of payments made to clinicians needs to improve. The register of the General Medical Council (GMC) should be expanded to include a list of financial and non-pecuniary interests for all doctors, as well as doctors’ particular clinical interests and their recognised and accredited specialisms. In addition, there should be mandatory reporting for the pharmaceutical and medical device industries of payments made to teaching hospitals, research institutions and individual clinicians.The government accepts recommendation 8 in principle. The government accepts in principle the first part of recommendation 8, for greater transparency of doctors’ interest.We agree that lists of doctors’ interests should be publicly available, but we do not think that the GMC register is the best place to hold this information. It is absolutely crucial that any published list of interests is meaningful and accessible to patients. Our approach is therefore for publications of interests to be held by healthcare providers at the local level, because patients know where healthcare professionals work, and are more likely to seek information from the organisation that provides their treatment and care. Additionally, at the local level healthcare providers can ensure patients have the necessary support to understand the relevant informationWe also believe that it is not just doctors who must declare their interests, but rather all registered healthcare professionals. That is why we are going further than the recommendation, and we will make it a regulatory requirement that all registered healthcare professionals must declare their relevant interests. Registered healthcare professionals will be required to declare their relevant interests to their employer, contractor, or the organisation where they are providing services. All healthcare providers will be required to collect, monitor, and publish a list of their employee’s relevant interests. At the local level, healthcare providers must ensure that all declarations of interest are publicly available for patients to access, and providers can then ensure there is meaningful oversight of publications of interests.These changes build on current NHS guidance, which states that all staff should declare interests and organisations should publish the interests of decision making on their website. These changes will also extend publication of declarations of interest to the private sector. We will continue to work with healthcare organisations across the NHS and independent sector, as well as regulators, to ensure there is appropriate implementation, governance, and enforcement of this approach.The government also accepts in principle the second part of recommendation 8, for mandatory reporting of payments from the pharmaceutical and medical device industry.The government agrees that transparency of medicine and medical device industry payments to clinicians and organisations is an important part of ensuring patient confidence. As with doctors’ interests, it is important that this information is published and easily accessible for patients.Regarding medicines, the government has listened to stakeholder concerns that the existing industry scheme is voluntary, and that more could be done to achieve consistent transparency in reporting of payments. We have listened to concerns from patient groups and others that a mandatory scheme is needed. We are exploring options to expand and reinforce current industry schemes, including making reporting mandatory through legislation.Regarding medical devices, we recognise that the sector does not have any formal scheme for reporting payments. We have listened to stakeholder concerns that the current situation means that that patients lack crucial information on a highly important area of clinical decision-making. We will work with the devices industry and other stakeholders on the options for introducing reporting of payments for the medical device sector, including making reporting mandatory through legislation.Recommendation 9: the government should immediately set up a task force to implement this review’s recommendations. Its first task should be to set out a timeline for their implementation.The government accepts recommendation 9 in part.As set out in the Statement of 11 January, the government has no plans to establish an independent taskforce to implement the Report’s recommendations. As is convention with independent reports and inquiries, conclusions and recommendations are passed to government for consideration.The government has considered the Report’s recommendations carefully, and our response sets out an ambitious programme of change. We have accepted the majority of the Report’s 9 strategic recommendations and 50 Actions for Improvement.The actions set out in this response are a combination of well-established programmes of work and new initiatives. The government is committed to making rapid progress on all the areas set out in this response. To ensure that Parliament and patients can continue to hold the government to account, we will publish an update on progress to implement the government response in 12 months’ time.ConclusionThe Report of the IMMDS Review is a powerful call to action, and we are determined to deliver meaningful change through the government response.I would like to once again thank the Rt Hon Jeremy Hunt MP and the Rt Hon Theresa May MP for commissioning this landmark review, and to thank Baroness Cumberlege and the Review team for their diligence and dedication in conducting this review.Above all, I would like to once again recognise and thank the women and their families, who fought to bring these issues to light and to have their stories heard.The Report highlights a stark inequality in the healthcare system. We cannot ignore the fact that the Report of the IMMDS Review is one of several independent reports and inquiries to have concluded that our healthcare system disproportionately fails to listen to women and keep them safe. This government is determined to change this, not least through our work to develop the first ever Women’s Health Strategy for England later this year.I am depositing a copy of the Government Response and the Independent Report of the Patient Reference Group in the Libraries of both Houses.

Ministry of Housing, Communities and Local Government

HOUSING UPDATE

Lord Greenhalgh: My Rt Hon. Friend, the Secretary of State for the Ministry of Housing, Communities and Local Government (Robert Jenrick) has today made the following Written Ministerial Statement:Today marks the next major step on our path towards a robust, but proportionate, building safety regime. We seek a regime that delivers high standards of safety for people’s homes, particularly those which are high-rise and therefore somewhat higher risk whilst providing reassurance to leaseholders, residents and the market that the overwhelming majority of homes are safe.The Grenfell Tower tragedy and subsequent independent review of Building Regulations led by Dame Judith Hackitt, exposed serious issues in the regulatory system and construction of some high-rise buildings: developers cladding buildings in combustible materials that should never have been used; construction product manufacturers ignoring safety rules, gaming the system and rigging the results of safety tests; building owners failing to take responsibility for ensuring the safety of their residents; and the Government’s regulatory system lacking the strength and oversight to identify these failings and enforce standards.That is why, as a Government, we have taken a safety first approach in our response to buildings that we know to be higher risk – those over 18m. We have:Engaged Fire and Rescue Services to survey all buildings over 18m to assess their safety;Targeted Government funding at the buildings we know to be at greatest risk if a fire spreads - those over 18m with unsafe cladding – investing over £5 billion to make those buildings safe as quickly as possible;Banned the use of combustible materials in new buildings over 18m, providing industry with a clear standard for the construction of new builds;Incentivised the installation of central alarm systems in high-rise buildings with a waking watch through our Waking Watch Relief Fund; andToday, we have reached Second Reading of the Building Safety Bill, our landmark legislation that brings forward the biggest improvements in building safety in a generation. The Bill introduces an enhanced safety regime for higher-risk buildings, defined as those over 18m (or seven storeys) - we have enshrined this scope on the face of the Bill.The Fire Safety Act, which received Royal Assent in April will also ensure that the external walls of buildings are considered as part of routine fire risk assessments for all multi-occupied residential buildings.We are making good progress in bringing those high-rise buildings with unsafe cladding up to an acceptable standard of safety: Over 95% of buildings with ‘Grenfell type’ cladding identified at the beginning of last year have been fully remediated or have workers on site. By the end of the year, I expect works to have started on all buildings barring a handful of cases where ACM cladding has only recently been identified or where remediation works are especially complex. This means around 16,000 homes have been fully remediated of unsafe ACM cladding – an increase of around 4000 since the end of last year.Despite many buildings owners failing to provide adequate basic information, almost 700 buildings, with estimated remediation costs of £2.5 billion are proceeding with a full application to the Building Safety Fund. We have already allocated £540 million which means owners of over 60,000 homes and properties within high-rise blocks are covered by Building Safety Fund applications and can be reassured that unsafe non-ACM cladding on their blocks will be replaced. All eligible applications currently made to the Building Safety Fund will proceed, and we are working with applicants to ensure work gets underway as soon as possible. For any buildings that may have missed the original registration deadline we will be reopening for registrations in the Autumn. This will ensure we meet our commitment to fully fund the cost of replacing unsafe cladding for all leaseholders in residential buildings 18m and over in England. We currently forecast that works of some form will be supported by the Building Safety Fund on over 1,000 high-rise buildings.191 buildings are already benefitting from the £30 million Waking Watch Relief Fund. More buildings will benefit from the fund as final decisions are made on applications. Leaseholders are expected to save on average £137 per month, or over £1,600 a year, on Waking Watch costs.It is right that we have taken a safety first approach and safety will always continue to be our priority and inform the decisions we make. However, it is also thankfully the case that fires in homes in England are extremely rare in all dwellings and I have become concerned to hear from leasehold residents feeling trapped in blocks of flats, particularly those lower than 18m in height. In many cases these residents have been held back from selling their homes and moving on with their lives because of excessive caution in the lending, surveying and fire risk assessment market. Understandably, this has caused some residents worry over safety and unnecessary costs due to a failure, on the part of many parties, to adequately explain the true nature of risk which statistics demonstrate is very low. I want to be clear – the vast majority of residents in all homes, including blocks of flats, should not feel unsafe in their homes. Residents need to be urgently reassured and the evidence presented clearly to them. And, other market participants need to exercise their professional judgement and not perpetuate this climate of extreme caution. Driven by these concerns for leasehold residents, earlier this year I asked a small group of experts on fire safety to consider the evidence and advise me on steps that should be taken to ensure that a more risk-proportionate approach is taken to fire safety in blocks of flats. An approach through which genuine life safety risks are tackled swiftly, and where all blocks of flats meet statutory requirements on life safety, but where excessive caution and unnecessary costs are avoided. The experts I commissioned were: Dame Judith Hackitt, Chair of the Independent Review of Building Regulations and Fire SafetySir Ken Knight, Chair of the Independent Expert Advisory Panel on building safety following the Grenfell Tower FireRon Dobson, former London Fire CommissionerRoy Wilsher, adviser on fire reform, former Chief Fire OfficerThe key finding of this advice is clear – there is no evidence of systemic risk of fire in blocks of flats: Dwelling fires are at an all-time low since comparable statistics started to be collected in 1981/82. This is despite the fact that, in 2020, people spent significantly greater amount of time in their homes as a result of Covid restrictions.The vast majority of fires (91%) were in houses, bungalows, converted or low rise (three storeys or lower) flats or other properties, while only 9% were in blocks of flats of four storeys or more.Very few fires spread from the room where they start. In 2019/20, 7% of fires spread beyond the room of origin in blocks of flats over four storeys, compared with 9% in blocks below four storeys and 14% in houses, bungalows, converted flats and other dwellings.Any death in a fire is tragic, thankfully only a small proportion of fires resulted in a fire-related fatality in 2020: 176 people in total lost their lives in dwelling fires (down from 257 just a decade earlier), of which only 10 fatalities were in blocks of flats of four or more storeys. This is the lowest number of fatalities from fire since comparable statistics began to be collected forty years ago. I thank the Fire and Rescue Services for all that they do to keep us safe.On this basis, the expert advice, which I have published today on gov.uk, reaches five recommendations to correct the disproportionate reaction we have seen in some parts of the market: EWS1 forms should not be a requirement on buildings below 18m.In the small number of cases where there are known to be concerns these should be addressed primarily through risk management and mitigation.There should be a clear route for residents/leaseholders to challenge costly remediation work and seek assurance that proposals are proportionate and cost effective.Government should work with the shadow Building Safety Regulator to consider how to implement an audit process to check that fire risk assessments are following guidelines, not perpetuating the risk aversion we are witnessing, in some instances, at the present time.Fire risk assessors, and lenders should not presume that there is significant risk to life unless there is evidence to support this. This would ensure that they respond only to the evidence and adopt a far more proportionate and balanced approach.Having carefully considered these recommendations the Government will support and act upon them. Delivering real change for leaseholders requires a concerted effort from all participants in the market including, Government, the Royal Institute of Chartered Surveyors (RICS), lenders and fire experts, and we have been working intensively with these groups. As Government, we are clear that we support the expert advice and the position that EWS1s should not be needed for buildings less than 18m. This position is a significant step and one supported by the National Fire Chiefs Council and the Institute of Fire Engineers. Government will work with the Health and Safety Executive and others to explore ways to deliver an effective fire risk assessment audit process that ensures assessments are carried out in a risk-proportionate manner and do not recommend unnecessary and costly remediation works where they are not genuinely needed. We will also rapidly progress exploration of options to provide a clear route for residents and leaseholders to challenge costly remediation work. It is crucial that all market participants show the necessary leadership to help end the nightmare that has impacted the lives of many leaseholders. I thank everyone for coming to the table and supporting the Government’s efforts. I am pleased that all major lenders have welcomed this advice. HSBC UK, Barclays, Lloyds Banking Group and others have said that the expert advice, and our clear response, paves the way for EWS1 forms to no longer be required for buildings below 18m and will help further unlock the housing market. I hope and expect other lenders to follow suit swiftly. I am very grateful to these organisations for their constructive work with Government on this critical issue - I appreciate that it is a complex and some parties have further work to do in which the Government will support them. Through concerted, cross-market action I believe we can help open up the housing market, allowing thousands to buy, sell or re-mortgage their homes. This work will be progressed alongside existing steps we are taking to ensure a proportionate response to risk, this includes: Development of a new more risk-proportionate guidelines for fire risk assessors, including PAS9980. The Consolidated Advice Note, the product of the need for reliable safety information in the period following the Grenfell Tragedy will shortly be retired.Launching a Government-backed professional indemnity insurance scheme for qualified professionals conducting external wall system assessments. This is aimed at supporting those qualified professionals to complete EWS1 forms, where genuinely needed, in a risk-proportionate manner and will help ensure that there is sufficient capacity in the market to allow EWS1 forms to be completed quickly, helping people to buy, sell and re-mortgage their homes. With the comfort Government backing provides, professionals must exercise their judgement in a proportionate manner and refrain from proposing works that are not strictly necessary to achieve an acceptable standard of fire safety - and risk management and mitigation should always be considered before costly remediation.Working with the National Fire Chiefs Council to re-emphasise the scope of the simultaneous evacuation guidance, the temporary nature of waking watches and the alternative proportionate fire safety interventions to be considered before implementing a waking watch, particularly in buildings below 18m. Latest indications are that the number of residential blocks between 11m and 18m in height are 61,000. Data from one major lender suggests that 7% of flats in buildings up to 6 storeys currently require an EWS1 assessment and in a majority of these cases EWS1s are found to already be held, leading to requests for an EWS1 form on approximately 5% of flats. Of these buildings, the vast majority do not need any remediation work at all. This is reinforced by initial results of surveys of medium rise blocks of flats indicating that the vast majority are free from serious safety risks associated with combustible cladding requiring remediation, and from any associated costs. If the market reacts as we would hope to the expert advice these numbers should reduce yet further and hundreds of thousands of leaseholders will be able to get on with buying, selling or re-mortgaging their homes. To reiterate, the Government sees no reason why an EWS1 form, or equivalent, should be requested on buildings below 18m. For the very small number where works are required, the presumption in favour of mitigation should also reduce remediation costs. It is my expectation that these actions will significantly ease the challenges faced by the vast majority of leaseholders looking to buy or sell flats in high-rise buildings and ensure that leaseholders do not face huge bills for unnecessary remediation works. In the very small minority of cases where remediation works are identified in 11m – 18m buildings as part of the normal statutory requirement for buildings to have an up to date fire risk assessment, I can reaffirm that leaseholders will be protected from unaffordable costs by a generous financing scheme through which their monthly cladding repayment costs will not exceed £50.

Home Office

NCA Remuneration Review Body Report 2021

Baroness Williams of Trafford: My rt hon Friend the Secretary of State for the Home Department (Priti Patel) has today made the following Written Ministerial Statement:I am today announcing the government’s decision on pay for the National Crime Agency (NCA) for 2021-22. The government recognises that public sector workers play a vital role in the running of our public services, including in their remarkable commitment to keeping the public safe in the continuing fight against Covid-19. The government received the NCA Remuneration Review Body (NCARRB) report on 2021 pay for the NCA on 2 July. This will be laid before Parliament today (CP 467) and published on Gov.uk. I would like to thank the Chair and members of the Review Body for their work on gathering evidence from the NCA, the Home Office, HM Treasury and the Trade Unions, resulting in their detailed, comprehensive report. The government values the independent expertise and insight of NCARRB and takes on board the useful advice and principles set out in response to my remit letter of 14 January 2021. As set out at the Spending Review (2020), there will be a pause to headline pay rises for the majority of public sector workforces in 2021-22. This is in order to ensure fairness between public and private sector wage growth, as the private sector was significantly impacted by the Covid-19 pandemic in the form of reduced hours, supressed earnings growth and increased redundancies, whilst the public sector was largely shielded from these effects. This approach will protect public sector jobs and investment in public services, prioritising the lowest paid, with those earning less than £24,000 (Full Time Equivalent) receiving a minimum £250 increase. The pause ensures we can get the public finances back onto a sustainable path after unprecedented government spending on the response to Covid-19. My remit letter informed NCARRB that I would not be seeking a recommendation for pay uplifts in the remit group for 2021/22, in the light of the public sector pay pause but invited views on areas including the operational context in which the Agency is operating, its ongoing pay strategy and longer-term plans for its workforce. NCARRB was also invited to comment on how the £250 uplift is best implemented so as to avoid leapfrogging. The NCA has considered options to avoid leapfrogging, including the impacts on its pay strategy, and considers the most effective way to remediate this is by paying a percentage uplift to those who are at risk of being leap-frogged, which is applicable to those earning less than £24,000. The government accepts the NCARRB observations in full and the awards will be fully funded within the NCA’s existing budget.

Police Pay

Baroness Williams of Trafford: My rt hon Friend the Secretary of State for the Home Department (Priti Patel) has today made the following Written Ministerial Statement:The seventh report of the Police Remuneration Review Body (PRRB) was published today. The Body considered the pay and allowances for police officers up to and including the chief officer ranks in England and Wales. The Government appreciates and values the independent, expert advice and contribution that the PRRB makes and thanks the Chair and members for their detailed considerations and observations. We absolutely recognise the bravery, commitment and professionalism of our police who work night and day to keep us safe and we will continue to give them the resources, tools and powers they need to protect the public. The Government recognises that public sector workers play a vital role in the running of our public services, including in their remarkable commitment to keeping the public safe in the continuing fight against Covid-19. As set out at the Spending Review (2020), there will be a pause to headline pay rises for the majority of public sector workforces in 2021-22. This is in order to ensure fairness between public and private sector wage growth, as the private sector was significantly impacted by the Covid-19 pandemic in the form of reduced hours, supressed earnings growth and increased redundancies, whilst the public sector was largely shielded from these effects. This approach will protect public sector jobs and investment in public services, prioritising the lowest paid, with those earning less than £24,000 (full-time equivalent) receiving a minimum £250 increase. The pause ensures we can get the public finances back onto a sustainable path after unprecedented Government spending on the response to Covid-19. The PRRB recommended that the minimum rates for Police Constable Degree Apprentice starting pay and pay point 0 of the constable scale should be uplifted by £250, and that all officers with a basic salary above these minima but below £24,000 (on a full-time equivalent basis) should receive a consolidated pay award of £250. The Government has accepted the PRRB’s recommendation in full. The pay award will take effect from 1 September 2021. Officers who have not reached the top of their pay band will also continue to receive incremental progression pay worth at least 2% of salary, subject to satisfactory performance.

Cabinet Office

Response to the 2021 Senior Salaries Review Body Report

Lord Agnew of Oulton: My Rt. Hon. Friend, the Chancellor for the Duchy of Lancaster (Michael Gove MP), has today made the following written statement:I am today announcing the Government’s decision on pay for the senior civil service, senior military, senior managers in the NHS and the judiciary.The Government recognises that public sector workers play a vital role in the running of our public services, including in their remarkable commitment to keeping the public safe in the continuing fight against COVID-19.The Government received the Senior Salary Review Body’s report on 2021 pay for the senior civil service, senior military, senior managers in the NHS, and the judiciary on 28 June 2021. This will be presented to Parliament and published on GOV.UK.The Government welcomes the Senior Salary Review Body’s report and is grateful to the Chair and members for their valuable advice, observations and strategic recommendations outlined within it.As set out at the Spending Review (2020), there will be a pause to headline pay rises for the majority of public sector workforces in 2021-22. This is in order to ensure fairness between public and private sector wage growth, as the private sector was significantly impacted by the COVID-19 pandemic in the form of reduced hours, suppressed earnings growth and increased redundancies, whilst the public sector was largely shielded from these effects. This approach will protect public sector jobs and investment in public services, prioritising the lowest paid, with those earning less than £24,000 (Full Time Equivalent) receiving a minimum £250 increase. The pause ensures we can get the public finances back onto a sustainable path after unprecedented government spending on the response to COVID-19.In line with this, the Senior Salary Review Body was not asked to make any recommendations for consolidated pay increases for its remit group this year.This is the first year the Senior Salary Review Body’s remit group has been expanded to include all Very Senior Managers (VSMs) within the NHS and Executive Senior Managers (ESMs) within the Department of Health and Social Care’s (DHSC) arms-length bodies. They were asked to make observations on the current levels of pay for this group to use as a baseline for future years. The Government is pleased that the Senior Salary Review Body agrees that existing pay levels are appropriate and that their observations broadly reflect existing themes within the development of a new pay framework for VSMs within the NHS.The Senior Salary Review Body made no specific pay recommendations for the 2021/22 pay year for the Senior Civil Service and judiciary and made two recommendations for the senior military.The Government accepts the Senior Salary Review Body’s recommendation to change the annual Incremental Progression date for senior military officers from 1 April to the anniversary of the date of promotion for senior military officers of 2-star rank and above.The Government accepts the Senior Salary Review Body’s recommendation to maintain the current pay differentials for senior medical and dental officers.

Notification to Parliament of a Contingent Liability: Indemnification to UNFCCC

Lord True: My Rt. Hon. Friend, The Chancellor of the Duchy of Lancaster (Michael Gove MP), has today made the following written statement:I am writing to notify Parliament of a contingent liability that will be created when the government signs the Host Country Agreement for hosting the 26th session of the Conference of the Parties to the United Nations Framework Convention on Climate Change (UNFCCC), known as COP26. The Host Country Agreement (HCA) will be signed in October 2021, ahead of the conference taking place in Glasgow in November. The HCA includes a standard liability clause, which commits the host country to indemnify the UN or its personnel against any successful claim in respect of the Conference.To mitigate against HMG being liable for covering incidents outside of our control, we have asked the UNFCCC to take out an insurance policy to cover claims arising from misconduct or negligence on the part of UNFCCC or its personnel, which they are willing to do and have done for previous COPs. We believe it is appropriate to provide this indemnity to the UN as it is a mandatory requirement for host countries of COP. Although the liability is technically uncapped, my officials have reviewed incidents at previous COPs, and have assessed that the risk of the indemnity being called upon is low.

Department for Digital, Culture, Media and Sport

Update on the Government response to the loot box call for evidence

Baroness Barran: My honourable friend the Minister of State for Digital and Culture, Caroline Dinenage MP, has made the following statement:I would like to thank everyone who has taken the time to respond to the loot box call for evidence. The call for evidence received over 30,000 responses which clearly reflects the immense amount of interest in the issue.The Government takes concerns about potential harms relating to loot boxes in video games seriously. That is why we are continuing to thoroughly evaluate the evidence received to determine solutions that are both robust and proportionate in response to the issues identified from the evidence received. This will be set out in the government response which will be published in the coming months.Ensuring that video game players are protected is also a responsibility that the Government shares jointly with the games industry. In recent months, we have continued to engage heavily with many in the industry about loot box concerns to determine the most effective solutions to issues identified from the evidence. This includes holding a ministerial roundtable with a number of games companies. Following the call for evidence we commissioned an external rapid evidence review and we are evaluating the findings of this alongside the evidence received from responses.

Parliamentary Works Sponsor Body

Parliamentary Works Sponsor Body: spokesperson

Lord Best: I wish to inform the House that I have been appointed by the Parliamentary Works Sponsor Body as its new spokesperson in the House of Lords. I take over this role from Baroness Scott of Needham Market, who has held the role since the Sponsor Body became a statutory organisation in April 2020. I would like to place on record the thanks of all the Board members and officers of the Sponsor Body to Baroness Scott for the tremendous energy and drive she brought as the Sponsor Body spokesperson.As proposed by the Procedure Committee (1st Report of Session 2019-21, HL Paper 29), the role of the spokesperson is to:Respond to questions for written answer;Respond to oral questions;Participate in debates, including responding to questions for short debate, on behalf of the Sponsor Body;Make written statements;Move the resolution to approve the proposed restoration works and funding (required by section 7 of the Parliamentary Buildings (Restoration and Renewal) Act 2019).The Committee's report was agreed by the House on 17 March 2020 (HL Hansard, Volume 802, cols 1388-89).I have been involved with the Restoration and Renewal Programme since I was first appointed to the Sponsor Board in March 2020. I look forward to working in this new role and engaging with Members across the House in the coming months, which will be a critical period as the Sponsor Body and Delivery Authority develop the detailed and costed plan for the restoration and renewal of the Palace of Westminster.